血液灌流联合血液透析治疗尿毒症顽固性皮肤瘙痒不同证候间疗效的临床观察

目的：观察血液灌流联合血液透析（HDP）治疗尿毒症皮肤瘙痒患者不同证候间的疗效差异。方法：将58例尿毒症顽固性皮肤瘙痒患者,按证候量表分为湿毒内停组、血虚生风组,采用血液灌流联合血液透析治疗,每月4~8次,共治疗8周。治疗前后测定各组瘙痒评分及血清全段甲状旁腺激素（iPTH）和磷、镁等阳离子血清水平。结果：治疗后两组患者瘙痒症状均有明显缓解,尤以血虚生风组疗效显著,且与湿毒内停组疗效相比差异有统计学意义。结论：血液灌流联合血液透析能有效地改善患者皮肤瘙痒症状,且不同证候间疗效存在差异,这一结果为进一步寻找中医证候的生物学标记及临床治疗均提供了参考。

Clinical Observation on Curative Effect of Hemoperfusion Combined with Hemodialysis in the Treatment of Intractable Pruritus of Uremia with Different Syndromes

Objective： To observe the different curative effects of hemoperfusion combined with hemodialysis（ HDP） therapy treating patients with uremic cutaneous pruritus with different syndromes. Methods： According to the syndrome scale,fifty eight cases of uremia patients with intractable pruritus were divided into inside stasis of wet poison group,and blood deficiency generating wind group. Patients were given hemoperfusion combined with hemodialysis therapy,four to eight times a month,for eight weeks. Pruritus score before and after treatment and cationic serum levels such as serum segment parathyroid hormone（ iPTH） and phosphorus,magnesium etc were measured in each group. Results： After treatment,prutitus were obviously relieved on patients in both groups,especially for blood deficiency generating wind group,and the curative effect was statistically different from that of the inside stasis of wet poison group. Conclusion： Hemoperfusion combined with hemodialysis can effectively improve patients＇ pruritus symptoms,and curative effect is different among different syndromes. These results can provide reference for further biological markers of TCM syndromes and the clinical treatments.